MR. LUIS FERNANDO CARRILLO (NPI# 1083617658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083617658 |
| Entity Type | Individual |
| Full Name | MR. LUIS FERNANDO CARRILLO |
| Other Name | MR. FERNANDO CARRILLO |
| Credential | FNP |
| Practice Address |
6538 N Kerby Ave Portland OR 97217-1939 |
| Practice Telephone | 5032838351 |
| Mailing Telephone | 5032838351 |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
OR | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OR | OSBN WORKER'S COMP | ANP 397 | 01 |
| OR | 0022959 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598769119 | Luis Enrique Carrillo | Preventive Medicine | 2200 Osprey Blvd, Ste 103, Bartow, FL 33830-3308 | 2005-06-10 |
| 1194226480 | Luis Carrillo | Technician | 2780 S Jones Blvd Ste 105b, Las Vegas, NV 89146-5628 | 2018-02-22 |
| 1215315239 | Luis Carrillo | Counselor | 2750 E Washington Blvd Ste 230, Pasadena, CA 91107-1449 | 2015-05-11 |
| 1952741621 | Luis Felipe Carrillo | Pathology | 9200 W Wisconsin Ave, Milwaukee, WI 53226 | 2013-06-26 |
| 1821092370 | Luis Eduardo Carrillo | Internal Medicine | 130 Pablo St, Lakeland, FL 33803-3818 | 2005-06-10 |
| Street Address |
6538 N KERBY AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97217-1939 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326531666 | Working Class Medicine LLC | Clinic/Center | 2133 N. Willis Blvd, Studio D, Portland, OR 97217 | 2018-06-12 |
| 1235643602 | Autism Outreach of Oregon | Occupational Therapist | 10350 N Vancouver Way #1043, Portland, OR 97217 | 2017-11-21 |
| 1689183717 | Kai-uwe H. Hahn Dmd Dba Edelweiss Dental | Clinic/Center | 3503 N Lombard Street, Portland, OR 97217 | 2017-09-20 |
| 1407308125 | Occupational Health Centers of The Southwest, P.a. (tx) | Clinic/Center | 3449 N Anchor Street, Ste 300a, Portland, OR 97217 | 2016-10-28 |
| 1750740577 | Sheila Amoo | Adult Companion | 236 N Killingworth St. Apt.b104, Portland, OR 97217 | 2016-02-22 |
| 1801282199 | Justine Osborn | Specialist | 4310 N. Interstate Ave, Portland, OR 97217 | 2015-04-13 |
| 1578957742 | Paul Buck Md, Dds, PC | Clinic/Center | 3332 N Lombard St, Suite C, Portland, OR 97217 | 2015-03-25 |
| 1295158186 | Rebecca Bulleri | Massage Therapist | 5416 N. Maryland Ave, Portland, OR 97217 | 2014-01-28 |
| 1659793107 | Shellmire Unlimited, P.C. | Community/Behavioral Health | 4134 N Vancouver Avenue, Suite 102, Portland, OR 97217 | 2014-01-16 |
| 1417207994 | Sportland Acupuncture LLC | Acupuncturist | 1025 N Humboldt, Portland, OR 97217 | 2012-09-12 |
| Find all providers in zip 97217 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043822794 | Danielle Langer | Nurse Practitioner | 35 Ridgeview Rd, Portland, CT 06480-4014 | 2020-08-23 |
| 1508476250 | Harrington Health Clinic | Nurse Practitioner | 310 Nw Glisan Street, Portland, OR 97209 | 2020-08-07 |
| 1114566650 | Sadie Garnache-poirier | Nurse Practitioner | 65 W Commercial St Ste 107, Portland, ME 04101-4789 | 2020-01-02 |
| 1902441629 | Jennifer Marie Colpitts | Nurse Practitioner | 1600 Congress St Ste B, Portland, ME 04102-2148 | 2019-11-18 |
| 1477102689 | Raquel A Bishop | Nurse Practitioner | 12400 Nw Cornell Rd Ste 100, Portland, OR 97229 | 2019-09-10 |
| 1265081640 | Christina Lee | Nurse Practitioner | 144 State St # 1, Portland, ME 04101-3776 | 2019-09-09 |
| 1407401474 | Abby Christine Vopal | Nurse Practitioner | 66 Bramhall St Fl 1, Portland, ME 04102-3355 | 2019-08-07 |
| 1770145294 | Cynthia Marie Martinez | Nurse Practitioner | 1145 Austin St, Portland, TX 78374-2013 | 2019-07-04 |
| 1528532306 | Matthew James Keelin | Nurse Practitioner | 6801 Ne Cornfoot Rd, Portland, OR 97218-2743 | 2019-01-15 |
| 1659847580 | Colleen Jeanette Scott | Nurse Practitioner | 650 Nw Irving St, Portland, OR 97209-1272 | 2018-10-18 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.